Trump blocks payments under ‘Obamacare’ programme

washington — The Trump administration said on Saturday it’s freezing payments under an ‘Obamacare’ programme that protects insurers with sicker patients from financial losses, a move expected to add to premium increases next year.

At stake are billions in payments to insurers with sicker customers.

In a weekend announcement, the Centers for Medicare and Medicaid Services said the administration is acting because of conflicting court ruling in lawsuits filed by some smaller insurers who question whether they are being fairly treated under the programme.

The so-called ‘risk adjustment’ programme takes payments from insurers with healthier customers and redistributes that money to companies with sicker enrollees. Payments for 2017 are $10.4 billion. No taxpayer subsidies are involved.

The idea behind the programme is to remove the financial incentive for insurers to ‘cherry pick’ healthier customers. The government uses a similar approach with Medicare private insurance plans and

It will undermine Americans’ access to affordable coverage, particularly those who need medical care the most Scott Serota, The Blue Cross Blue Shield Association’s president

the Medicare prescription drug benefit.

Major insurer groups said on Saturday the administration’s action interferes with a programme that’s working well.

The Blue Cross Blue Shield Association, whose members are a mainstay of Affordable Care Act coverage said it was “extremely disappointed” with the administration’s action.

The Trump administration’s move “will significantly increase 2019 premiums for millions of individuals and small business owners and could result in far fewer health plan choices,” association president Scott Serota said in a statement. “It will undermine Americans’ access to affordable coverage, particularly those who need medical care the most.”

Serota noted that the payments are required by law, and said he believes the administration has the legal authority to continue making them despite the court cases. He warned of ‘turmoil’ as insurers finalise their rates for 2019.

America’s Health Insurance Plans, the main health insurance industry trade group, said in a statement that it is “very discouraged” by the Trump administration’s decision to freeze payments. —